Care Transitions Navigator

Sanitas Medical Centers; Katy (TX); On-site; USD 65,000 - 77,000; Full time

Job summary

Sanitas Medical Centers is seeking a Case Management Coordinator – Transitions of Care to support patients who frequently use the ER or are transitioning from inpatient facilities. The role coordinates timely follow-up, reduces unnecessary utilization, and connects patients with Sanitas and community resources to improve outcomes.

The position works to bridge care between hospital settings, primary care, and community services, ensuring effective communication and care plan follow-through to

Qualifications

• 3–5 years of experience in a clinical or community health setting.
• Experience in care coordination, discharge planning, or case management.
• High school diploma or equivalent.

Responsibilities

• Identify and engage patients with high ER utilization or recent hospital discharges.
• Coordinate and confirm timely post-ER or post-discharge follow-up appointments.
• Educate patients on appropriate care settings and how to navigate Sanitas services.
• Document care plans, patient interactions, and interventions in the EMR.
• Collaborate with PCPs, hospital staff, and payors to create and follow through on care plans.

Skills

Care coordination

Communication skills

Patient education

EMR documentation

Education

High school diploma

Tools

EMR systems

Job description

Sanitas Medical Centers is seeking a Case Management Coordinator – Transitions of Care to support patients who frequently use the ER or are transitioning from inpatient facilities. The role coordinates timely follow-up, reduces unnecessary utilization, and connects patients with Sanitas and community resources to improve outcomes.

The position works to bridge care between hospital settings, primary care, and community services, ensuring effective communication and care plan follow-through to